Sending the Right Smoke Signals

stephen clarke, 11 November 2011

By Emily Clarke

In 2001 Portugal abolished all criminal penalties for personal possession of drugs, from cannabis to heroin, in an attempt to reduce the number of drug related deaths and the spread of HIV/AIDS. After several years there was tentative discussion about the success of Portugal’s scheme (see for example the Economist’s article of August 2009) and although I don’t intend to add to the debate about the decriminalisation of drug use here, I do hope to discuss one particular element of Portugal’s policy that I find laudable.

Rather than sending drug users to serve jail time, Portugal decided instead to focus efforts and funding on prevention and cure. Campaigns were set up to advertise, for example, the dangers of sharing needles and initiatives were encouraged that offered help to those drug users wishing to wean themselves off the habit. Prioritising treatment over punishment is perhaps a principle that should be adopted more widely in the world of legalised, yet harmful, substances. In Britain there is already some evidence that this is being done with reference to smokers: for example, surgeons treating smokers for smoking-related diseases are strongly encouraging their patients to join the NHS “smokefree” initiative that helps people to quit. Eventually it is possible that calls might even be made for NHS treatment to be refused to smokers who do not sign up to such initiatives, thus using a mixture of carrot and stick to encourage healthier habits. Naturally this raises the question of where to draw the line but there seems to be no reason why the same principles couldn’t be applied in other areas, for example to long term alcohol abusers.

It is clear that the UK and many other countries are moving steadily towards making life more difficult for smokers in particular. Smoking bans in indoor public places are now in place in several countries including China – home to 1/3 of the world’s smokers, and Russia intends to bring in a law to the same effect from 2015. New York has even taken steps to ban smoking outside in public places. In the UK meanwhile it will now be illegal to sell cigarettes from vending machines and there are questions about whether or not smoking should be banned in cars where children are present. Even political leaders, from Obama to Nick Clegg are being encouraged to give up (although whether smoking was simply another convenient stick with which to beat Nick Clegg is open to debate.) These legal changes are welcome in that they do much to protect non-smokers from the effects of passive smoking. However I hope I am not alone in saying that, particularly in a country that is fortunate enough to have a National Health Service, there should be a greater focus on helping current smokers to quit and giving them as many incentives to do so as possible. Only then can we really be sure of doing as much as possible to protect, for example, the children of smokers, who are twice as likely to take up the habit as the children of non-smokers. A radical overhaul in the NHS treatment of smokers alongside increased funding for the Quit campaigns might, in this way, be a step in the right direction to achieve that mixture of incentive and aid.